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Multicenter Study
. 2020 Dec;37(14):1417-1424.
doi: 10.1055/s-0039-1693698. Epub 2019 Jul 31.

Team Stress and Adverse Events during Neonatal Tracheal Intubations: A Report from NEAR4NEOS

Rachel A Umoren  1 , Taylor L Sawyer  1 , Anne Ades  2 , Stephen DeMeo  3 , Elizabeth E Foglia  2 , Kristen Glass  4 , Megan M Gray  1 , James Barry  5 , Lindsay Johnston  6 , Philipp Jung  7 , Jae H Kim  8 , Jeanne Krick  1 , Ahmed Moussa  9 , Christine Mulvey  6 , Vinay Nadkarni  10 , Natalie Napolitano  11 , Bin Huey Quek  12 , Neetu Singh  13 , Jeanne P Zenge  5 , Justine Shults  14 , Akira Nishisaki  10 ; National Emergency Airway Registry for Neonates (NEAR4NEOS) Investigators
Affiliations
Multicenter Study

Team Stress and Adverse Events during Neonatal Tracheal Intubations: A Report from NEAR4NEOS

Rachel A Umoren et al. Am J Perinatol. 2020 Dec.

Abstract

Objective: This study aimed to examine the association between team stress level and adverse tracheal intubation (TI)-associated events during neonatal intubations.

Study design: TIs from 10 academic neonatal intensive care units were analyzed. Team stress level was rated immediately after TI using a 7-point Likert scale (1 = high stress). Associations among team stress, adverse TI-associated events, and TI characteristics were evaluated.

Result: In this study, 208 of 2,009 TIs (10%) had high stress levels (score < 4). Oxygenation failure, hemodynamic instability, and family presence were associated with high stress level. Video laryngoscopy and premedication were associated with lower stress levels. High stress level TIs were associated with adverse TI-associated event rates (31 vs. 16%, p < 0.001), which remained significant after adjusting for potential confounders including patient, provider, and practice factors associated with high stress (odds ratio: 1.90, 96% confidence interval: 1.36-2.67, p < 0.001).

Conclusion: High team stress levels during TI were more frequently reported among TIs with adverse events.

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Conflict of interest statement

None declared.

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